Efficacy and safety of antifungal prophylaxis in surgical intensive care unit patients: A systematic review and meta-analysis of randomized controlled trials.

Antifungal prophylaxis and pre-emptive strategies are employed to reduce the risk of such infections, although their effectiveness and safety remain subjects of debate.

Searches in the PubMed, Scopus, Google Scholar and Science Direct databases up to February 2025 identified 11 eligible studies.

While azoles were effective, polyenes and echinocandins did not show a significant effect.

No significant effect on overall mortality was observed (RR=0.99; 95% CI, 0.75-1.31; P=0.9186), and there was no increased risk of severe adverse events (RR=0.98; 95% CI, 0.70-1.36) or liver dysfunction (RR=0.91; 95% CI, 0.31-2.65).